Abstract
PURPOSE: The aim of our study was to determine the five-year survival of patients with colorectal carcinoma whose Dukes classification had changed following fat clearance of the mesocolon or mesorectum. METHODS: One hundred three patients with colorectal carcinoma were followed up at a special clinic for at least five years after surgery. The tumors from these patients had previously been given a Dukes classification before and after fat clearance. RESULTS: Four of the five patients whose Dukes status changed from B to C as a result of fat clearance died of malignant disease during the five-year follow-up period. After fat clearance it was apparent that Dukes B patients survived, on average, 11 months longer than Dukes C patients. A significantly increased mean number of positive nodes was found after fat clearance in Dukes C cases, both in those who were alive at five years and those who died of their malignant disease. CONCLUSIONS: The fat clearance technique is a useful aid to improving the accuracy of the Dukes classification and has prognostic significance. It should be used in specimens of colorectal carcinoma, which on initial examination appear to be Dukes B cases.
Similar content being viewed by others
References
Pickren JW. Nodal clearance and detection. JAMA 1975;231:969–71.
Cawthorn SJ, Gibbs NM, Marks CG. Clearance technique for the detection of lymph nodes in colorectal cancer. Br J Surg 1986;73:58–6.
Herrera-Ornelas L, Justiniano J, Castillo N, Petrelli NJ, Stule JP, Mittelman A. Metastases in small lymph nodes from colon cancer. Arch Surg 1987;122:1253–6.
Scott KW, Grace RH. Detection of lymph node metastases in colorectal carcinoma before and after fat clearance. Br J Surg 1989;76:1165–7.
Wolmark N, Fisher B, Wieand HS. The prognostic value of the modifications of the Dukes C class of colorectal cancer. Ann Surg 1986;203:115–21.
Hyder JW, Talbott TM, Maycroft TC. A critical review of chemical lymph node clearance and staging of colon and rectal cancer at Ferguson Hospital, 1977 to 1982. Dis Colon Rectum 1990;33:923–5.
Hojo K, Koyoma Y, Moriya Y. Lymphatic spread and its prognostic value in patients with rectal cancer. Am J Surg 1982;144:350–4.
Author information
Authors and Affiliations
About this article
Cite this article
Scott, K.W.M., Grace, R.H. & Gibbons, P. Five-year follow-up study of the fat clearance technique in colorectal carcinoma. Dis Colon Rectum 37, 126–128 (1994). https://doi.org/10.1007/BF02047533
Issue Date:
DOI: https://doi.org/10.1007/BF02047533